Clarissa Carelock-Lee

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

20069 Issued in SC

Practice address

1147 Ebenezer Rd
Rock Hill, SC 29732-2355

Phone

(803) 329-6648

NPI assigned

Jun 28, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ccarelocklee@rfml-sc.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Andrea Hope Speech Pathology LLC

  • Speech-Language Pathologist
  • Rock Hill, SC
  • NPI 1942568829
  NPD (past)
• Homestead Hospice of Columbia LLC

  • Community Based Hospice Care Agency
  • Irmo, SC
  • NPI 1245603455
  NPD (past)
• Creative Hospice Care Inc

  • Clinic/Center
  • Bogart, GA
  • NPI 1437897956
  NPD (past)
• Creative Hospice Care Inc

  • Community Based Hospice Care Agency
  • Roswell, GA
  • NPI 1942354675
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1184075475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322355",
            "telephone_number": "803-329-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322355",
            "telephone_number": "803-329-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARELOCK-LEE",
        "first_name": "CLARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "20069",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "20069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Cannon
• Kimberly M Cannon, MSW, LISW-CP
• Hannah King Cantrell
• Care First Professional Home Care Agency
• Care Provider Partners LLC
• Caring Hands Diagnostic Solutions
• Abigail Carley, BCABA
• Carolina ABA
• Carolina Anesthesia and Pain Management, LLC
• Carolina Asthma and Allergy Center, PA

• Gerontology Nurse Practitioner in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Gerontology Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.